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Steele MA, Power J, Smith HP. A Functional Approach to the Assessment of Non-Suicidal Self-Injury on YouTube. Issues Ment Health Nurs 2022; 43:808-817. [PMID: 35594485 DOI: 10.1080/01612840.2022.2072547] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
This research explores representations of non-suicidal self-injury (NSSI) on social media. The current study aims to examine the applicability of a functional model of NSSI to videos posted on YouTube by analyzing the 100 most viewed YouTube videos relating to NSSI at a point in time in 2018. Motivations for continued engagement in NSSI were examined for each content creator who posted one of the top 100 most viewed videos relating to NSSI. Categorizations of a content creator's motivation were based on Nock and Prinstein (2004) four-function model (FFM) of NSSI, in which the motivations, or functions, of NSSI are categorized by two dichotomous factors: (a) positive (i.e., involves the addition of a favorable stimulus) or negative (i.e., involves the removal of an aversive stimulus) and (b) automatic (i.e., intrapersonal) or social (i.e., interpersonal). Uploaders most endorsed automatic negative reinforcement (50%), followed by automatic positive (26%), social positive (3%), and social negative (3%). Considering the growing number of children and adolescents with near constant access to internet and social media, there may be implications for further development of safety measures for social media platforms. The results of this study may be valuable for parents, health care professionals, and educators, who should be aware of available social media content relating to NSSI and consider implementing additional media-literacy and media-safety education in school curriculums and programming for children and adolescents. Furthermore, health care professional should be aware that misconceptions of NSSI may have an impact on patients' willingness to seek treatment, or the attitude with which treatment is sought.
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Lee SE, Yim M, Hur JW. Beneath the surface: Clinical and psychosocial correlates of posting nonsuicidal self-injury content online among female young adults. COMPUTERS IN HUMAN BEHAVIOR 2022. [DOI: 10.1016/j.chb.2022.107262] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Kruzan KP, Whitlock J, Bazarova NN, Bhandari A, Chapman J. Use of a Mobile Peer Support App Among Young People With Nonsuicidal Self-injury: Small-scale Randomized Controlled Trial. JMIR Form Res 2022; 6:e26526. [PMID: 35006076 PMCID: PMC8787664 DOI: 10.2196/26526] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2020] [Revised: 05/10/2021] [Accepted: 11/23/2021] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Nonsuicidal self-injury (NSSI) is a widespread behavior among adolescents and young adults. Although many individuals who self-injure do not seek treatment, there is evidence for web-based help-seeking through web-based communities and mobile peer support networks. However, few studies have rigorously tested the efficacy of such platforms on outcomes relevant for NSSI recovery. OBJECTIVE The aim of this small-scale preregistered randomized controlled trial is to provide preliminary insight into the shorter- and longer-term efficacy of the use of a peer support app, TalkLife, in reducing NSSI frequency and urges and increasing readiness to change. In addition, we explore contact with informal support, interest in therapy, and attitudes toward professional help-seeking. METHODS Individuals aged 16-25 years with current (within 3 months) and chronic (>6 episodes in the past year) NSSI history were eligible to participate in this study. After baseline assessments, the intervention group was instructed to use the app actively (eg, post or comment at least three times per week) and the control group received weekly psychoeducational materials through email, for 8 weeks. Follow-up was assessed at 1 month and 2 months. Linear mixed modeling was used to evaluate condition and time point effects for the primary outcomes of NSSI frequency and urges, readiness to change, contact with informal support, interest in therapy, and attitudes toward professional help-seeking. RESULTS A total of 131 participants were included in the analysis. We evidenced a significant effect of condition on NSSI frequency such that the participants using the peer support app self-injured less over the course of the study (mean 1.30, SE 0.18) than those in the control condition (mean 1.62, SE 0.18; P=.02; η2=0.02). We also evidenced a significant condition effect of readiness to change such that the treatment participants reported greater confidence in their ability to change their NSSI behavior (mean 6.28, SE 0.41) than the control participants (mean 5.67, SE 0.41; P=.04; η2=0.02). No significant differences were observed for contact with informal support, interest in therapy, or attitudes toward professional help-seeking. CONCLUSIONS Use of the peer support app was related to reduced NSSI frequency and greater confidence in one's ability to change NSSI behavior over the course of the study period, but no effects on NSSI urges, contact with informal support, interest in therapy, or attitudes toward professional help-seeking were observed. The findings provide preliminary support for considering the use of mobile peer support apps as a supplement to NSSI intervention and point to the need for larger-scale trials. TRIAL REGISTRATION Open Science Foundation; https://osf.io/3uay9.
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Affiliation(s)
- Kaylee Payne Kruzan
- Center for Behavioral Intervention Technologies, Northwestern University, Chicago, IL, United States
| | - Janis Whitlock
- Bronfenbrenner Center for Translational Research, Cornell University, Ithaca, NY, United States
| | - Natalya N Bazarova
- Department of Communication, Cornell University, Ithaca, NY, United States
| | - Aparajita Bhandari
- Department of Communication, Cornell University, Ithaca, NY, United States
| | - Julia Chapman
- Bronfenbrenner Center for Translational Research, Cornell University, Ithaca, NY, United States
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Kruzan KP, Meyerhoff J, Biernesser C, Goldstein T, Reddy M, Mohr DC. Centering Lived Experience in Developing Digital Interventions for Suicide and Self-injurious Behaviors: User-Centered Design Approach. JMIR Ment Health 2021; 8:e31367. [PMID: 34951602 PMCID: PMC8742214 DOI: 10.2196/31367] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/18/2021] [Revised: 09/13/2021] [Accepted: 10/07/2021] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND The prevalence of self-injurious thoughts and behaviors (SITB) signals a growing public health crisis. Despite a recognized need for improved and scalable interventions, the field of SITB intervention faces several challenges: existing interventions are often time and resource intensive, most individuals with SITB do not seek formal mental health care, and efficacious treatments are characterized by small effects. Combined, these challenges indicate a need for improved SITB interventions for individuals in formal treatment and those who are not treatment engaged but are at high risk of worsening mental health and future suicide attempts. OBJECTIVE We present a methodological approach and set of techniques that may address these challenges by centering the lived experience of individuals with SITB in the process of developing needed services: user-centered design (UCD). METHODS We highlight the value of UCD in the context of digital interventions for SITB by describing the UCD approach and explicating how it can be leveraged to include lived experience throughout the development and evaluation process. We provide a detailed case example highlighting 3 phases of the early development process that can be used to design an intervention that is engaging and meets end-user needs. In addition, we point to novel applications of UCD to complement new directions in SITB research. RESULTS In this paper, we offer a 2-pronged approach to meet these challenges. First, in terms of addressing access to effective interventions, digital interventions hold promise to extend the reach of evidence-based treatments outside of brick-and-mortar health care settings. Second, to address challenges related to treatment targets and engagement, we propose involving individuals with lived experience in the design and research process. CONCLUSIONS UCD offers a well-developed and systematic process to center the unique needs, preferences, and perceived barriers of individuals with lived SITB experience in the development and evaluation of digital interventions.
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Affiliation(s)
- Kaylee Payne Kruzan
- Center for Behavioral Intervention Technologies, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States
| | - Jonah Meyerhoff
- Center for Behavioral Intervention Technologies, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States
| | - Candice Biernesser
- Department of Psychiatry, University of Pittsburgh Medical Center, Pittsburgh, PA, United States
| | - Tina Goldstein
- Department of Psychiatry, University of Pittsburgh Medical Center, Pittsburgh, PA, United States
| | - Madhu Reddy
- Department of Informatics, Donald Bren School of Information and Computer Sciences, University of California, Irvine, Irvine, CA, United States
| | - David C Mohr
- Center for Behavioral Intervention Technologies, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States
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Pritchard TR, Fedchenko CA, Lewis SP. Self-Injury Is My Drug: The Functions of Describing Nonsuicidal Self-Injury as an Addiction. J Nerv Ment Dis 2021; 209:628-635. [PMID: 33958550 DOI: 10.1097/nmd.0000000000001359] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
ABSTRACT Adolescents and emerging adults who engage in nonsuicidal self-injury (NSSI) often participate in online activity regarding their self-injury. Of particular importance are the potential benefits and risks associated with online NSSI activity, including how individuals describe their NSSI experiences. One way that individuals describe these experiences is by discussing NSSI as an addiction. Accordingly, we used thematic analysis to explore why individuals may use addiction references to describe their NSSI experiences. To do this, we examined 71 posts from a popular NSSI social network. Four themes emerged: difficulty inherent in stopping, authentication, warn others, and communicate the plight of the behavior. Findings highlight a number of avenues for research as well as implications for clinicians working with clients who self-injure perceive NSSI as an addiction. Mental health professionals can leverage their understanding of clients' perceptions of NSSI to better serve this population.
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Kruzan KP, Whitlock J, Bazarova NN. Examining the Relationship Between the Use of a Mobile Peer-Support App and Self-Injury Outcomes: Longitudinal Mixed Methods Study. JMIR Ment Health 2021; 8:e21854. [PMID: 33507154 PMCID: PMC7878111 DOI: 10.2196/21854] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2020] [Revised: 11/16/2020] [Accepted: 12/15/2020] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND Many individuals who self-injure seek support and information through online communities and mobile peer-support apps. Although researchers have identified risks and benefits of participation, empirical work linking participation in these web-based spaces to self-injury behaviors and thoughts is limited. OBJECTIVE This study aims to investigate the relationship between behavioral and linguistic traces on a mobile peer support app and self-injury outcomes. METHODS Natural use data and web-based surveys (N=697) assessing self-injury outcomes were collected from 268 users (aged 13-38 years; median 19; 149/268, 55.6% female) of a mobile peer-support app for 4 months. Participants were identified as having posted self-injury content using an internal classifier. Natural log data was used to predict self-injury outcomes in a series of multilevel logistic and linear regressions. RESULTS Greater engagement on a mobile peer-support app was associated with a decreased likelihood of self-injury thoughts (odds ratio [OR] 0.25, 95% CI 0.09-0.73) and fewer intentions to self-injure (b=-0.37, SE 0.09), whereas posting triggering content was associated with an increased likelihood of engaging in behaviors (OR 5.37, 95% CI 1.25-23.05) and having self-injury thoughts (OR 17.87, 95% CI 1.64-194.15). Moreover, viewing triggering content was related to both a greater ability to resist (b=1.39, SE 0.66) and a greater intention to self-injure (b=1.50, SE 0.06). CONCLUSIONS To our knowledge, this is the first study to connect naturally occurring log data to survey data assessing self-injury outcomes over time. This work provides empirical support for the relationship between participation in online forums and self-injury outcomes, and it articulates mechanisms contributing to this relationship.
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Affiliation(s)
- Kaylee Payne Kruzan
- Center for Behavioral Intervention Technologies, Northwestern University, Chicago, IL, United States
| | - Janis Whitlock
- Bronfenbrenner Center for Translational Research, Cornell University, Ithaca, NY, United States
| | - Natalya N Bazarova
- Department of Communication, Cornell University, Ithaca, NY, United States
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Brown RC, Fischer T, Goldwich DA, Plener PL. "I just finally wanted to belong somewhere"-Qualitative Analysis of Experiences With Posting Pictures of Self-Injury on Instagram. Front Psychiatry 2020; 11:274. [PMID: 32372983 PMCID: PMC7186324 DOI: 10.3389/fpsyt.2020.00274] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2019] [Accepted: 03/20/2020] [Indexed: 11/18/2022] Open
Abstract
Non-suicidal self-injury (NSSI) is a common phenomenon among adolescents, but is often not disclosed due to fear of stigmatization. Social media is frequently used to publish photos of NSSI and share experiences with NSSI. Objectives of this study were to find out more about the motivation for publishing NSSI content and to investigate the effect that sharing this content on social media has on young people. In the current study, we interviewed N=59 participants (mean age = 16.7 years [SD = 1.2 years]; 72.9% female), who had all posted NSSI content within the past month on the social media platform Instagram. Semi-structured interviews were conducted via the Instagram messaging app. Interviews were analyzed qualitatively, assisted by the Software Atlas.ti 7. Participants were asked about their motivation for and their experiences with posting NSSI content online. Motivations for posting pictures online were mainly social (connecting, disclosure, communicating), while self-focused reasons like documenting NSSI or recovery were also mentioned. All participants reported having received positive reactions (being offered help, connecting, receiving empathy), as well as negative comments (harassment, being misunderstood) to their own NSSI content by other Instagram users. Participants' reactions to other users' NSSI content on Instagram was often identification with the content or being triggered, but also wanting to offer help or sometimes even being deterred from NSSI. None of the participants mentioned successful referral to professional help through their online NSSI activity. One target for future interventions could therefore be social media, or other online platforms, where adolescents might be more easily reached. Mental health practitioners should be aware of their clients' online activity and encourage reflection upon positive and negative effects of viewing or sharing NSSI content online.
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Affiliation(s)
- Rebecca C Brown
- Department of Child and Adolescent Psychiatry and Psychotherapy, University of Ulm, Ulm, Germany
| | | | | | - Paul L Plener
- Department of Child and Adolescent Psychiatry and Psychotherapy, University of Ulm, Ulm, Germany.,Department of Child and Adolescent Psychiatry, Medical University of Vienna, Vienna, Austria
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Margherita G, Gargiulo A. A comparison between pro-anorexia and non-suicidal self-injury blogs: From symptom-based identity to sharing of emotions. PSYCHODYNAMIC PRACTICE 2018. [DOI: 10.1080/14753634.2018.1535326] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Affiliation(s)
- Giorgia Margherita
- Department of Humanistic Studies, University of Naples Federico II, Napoli, Italy
| | - Anna Gargiulo
- Department of Humanistic Studies, University of Naples Federico II, Napoli, Italy
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Smedley RM, Coulson NS. A practical guide to analysing online support forums. QUALITATIVE RESEARCH IN PSYCHOLOGY 2018. [DOI: 10.1080/14780887.2018.1475532] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
Affiliation(s)
- Richard M. Smedley
- Division of Rehabilitation and Ageing, Queen’s Medical Centre, Nottingham, United Kingdom
| | - Neil S. Coulson
- Division of Rehabilitation and Ageing, Queen’s Medical Centre, Nottingham, United Kingdom
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Deering K, Williams J. What activities might facilitate personal recovery for adults who continue to self-harm? A meta-synthesis employing the connectedness/hope and optimism/identity/meaning/empowerment framework. Int J Ment Health Nurs 2018; 27:483-497. [PMID: 28929615 DOI: 10.1111/inm.12387] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/06/2017] [Indexed: 11/28/2022]
Abstract
Self-harm is an international concern. While treatment in health care focusses on methods to reduce the act, there is less exploration in how to assist adults who are unable to minimize their self-harm. In order to aid these people, in the present systematic review, we employed a qualitative meta-synthesis to explore the lived experience of what activities might facilitate personal recovery for adults who continue to self-harm. Findings were interpreted by drawing on the CHIME framework; a taxonomy of personal recovery comprising of connectedness, hope and optimism, identity, meaning and purpose, and empowerment. The located activities in the review converged on different support groups, and although face-to-face groups were discovered, the majority highlighted the benefits of Internet forums where mutuality and reciprocity were key to promoting personal recovery. Adults desired time to share accounts of themselves, to develop connection and identity. Furthermore, hope was established by group members accepting that self-harm has a role, while congregating with others who did not judge the act. Helping relationships also promoted hope by having a balance between goals and protection against disappointment. The nature of writing online seemingly had cathartic properties fostering meaning, alongside empowerment being facilitated by adults controlling the narrative of their self-harm. It is hoped that these insights might guide self-harm research to develop beyond the confines of minimizing self-injury in health care.
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Affiliation(s)
- Kris Deering
- Faculty of Health and Applied Science, University of the West of England, Bristol, UK
| | - Jo Williams
- Faculty of Health and Applied Science, University of the West of England, Bristol, UK
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De Riggi ME, Lewis SP, Heath NL. Brief report: nonsuicidal self-injury in adolescence: turning to the Internet for support. COUNSELLING PSYCHOLOGY QUARTERLY 2018. [DOI: 10.1080/09515070.2018.1427556] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Melissa E. De Riggi
- Department of Educational & Counselling Psychology, McGill University, Montréal, Canada
| | | | - Nancy L. Heath
- Department of Educational & Counselling Psychology, McGill University, Montréal, Canada
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Abstract
Much debate surrounds the potential effects of self-harm forum use. Arguments in favor highlight factors such as providing access to a supportive community. However critical voice highlighting potential dangers such as forums serving as a platform to promote self-harm, clearly dominate the debate. Using an online questionnaire, the goal of the current study was to examine sociodemographic characteristics, the psychopathology of forum users, motives for participating, and subjective effects of self-harm forum use. A total of 309 self-harm forum users participated in this study. 3 heterogeneous user types with differing motives for visiting the forum and different usage effects were identified. The results question the assumptions that self-harm forums are a source of harm and point to their predominantly constructive and preventive functions.
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Jarvi SM, Swenson LP, Batejan KL. Motivation for and use of social networking sites: Comparisons among college students with and without histories of non-suicidal self-injury. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2017; 65:306-312. [PMID: 28362222 DOI: 10.1080/07448481.2017.1312410] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
OBJECTIVE This research examines potential differences in social network use and motivation for social network use by non-suicidal self-injury (NSSI) status. PARTICIPANTS 367 (73% women; Mage = 20.60) college students were recruited in November-December 2011. METHODS A random sample of 2,500 students was accessed through a university registrar to recruit students interested in an online survey assessing NSSI and various health-related behaviors. RESULTS Social network use and motivations for social networks did not differ by NSSI status. CONCLUSIONS Results suggest that it is not patterns of use or motivation to use social networks that could lead to concern about online behavior (i.e., behavior increasing risk of future NSSI) among those with NSSI history. Rather, future preventive and intervention efforts should address the NSSI-related content that is available online, since this is unregulated, often explicit, and commonly includes "pro-NSSI" content that may be problematic and increase risk among vulnerable individuals.
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Affiliation(s)
| | - Lance P Swenson
- a Department of Psychology , Suffolk University , Boston , MA , USA
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Parder ML, Vihalemm T. ”… if there's a party, then there's definitely alcohol”. Construction of partying practices and abstinence in Estonian youth forums. NORDIC STUDIES ON ALCOHOL AND DRUGS 2017. [DOI: 10.1515/nsad-2015-0054] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Aims Adolescents' abstinence from alcohol has not been much researched in terms of providing suggestions for prevention strategies. This study aims to fill that gap by offering a practice theory-inspired analysis of how the unwritten rules of partying practices are communicated between posters of Estonian youth forums. Data –These forums are novel objects of analysis in research on teenagers' alcohol use, and the article shares some topical experiences. Results The findings of the analysis show that non-drinking at teenagers' alcohol-related social gatherings is generally communicated as a non-tolerated individual performance that is seen to erode the whole collective partying practice. Young people therefore suggest in forums various mimicry strategies to justify non-drinking. Conclusions The article casts doubts about the efficiency of risk awareness raising and teaching individual skills in this context because they provide little help for those youngsters who have already been recruited into partying practices and who need peer legitimation to leave these practices. The authors pose suggestions for gradually making the current alcohol-related partying practices more tolerant of non-drinkers, thus opening “sub-culturally supported roads” to personal autonomy.
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De Riggi ME, Moumne S, Heath NL, Lewis SP. Non-Suicidal Self-Injury in Our Schools: A Review and Research-Informed Guidelines for School Mental Health Professionals. CANADIAN JOURNAL OF SCHOOL PSYCHOLOGY 2016. [DOI: 10.1177/0829573516645563] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Non-suicidal self-injury (NSSI), the immediate and deliberate destruction of one’s own body tissue, without suicidal intent, and not for purposes that are socially accepted, is a critical concern for youth in schools. Despite significant scholarly advances and increasing clinical awareness of NSSI, many school mental health professionals (MHPs) continue to report feeling ill equipped to support students who self-injure, and emphasize a need for formal education about NSSI and its management in schools. Thus, the first part of this article summarizes current NSSI research on prevalence, age of onset, gender differences, functions, risk factors, and associations with suicide. Emerging from this review, the second part offers research-informed recommendations for MHPs managing NSSI in schools, including guidelines for (a) identifying students at elevated risk of self-injury, (b) developing a protocol for school personnel’s initial response to student self-injury, (c) first-level assessment of NSSI, and (d) managing critical issues related to NSSI contagion and online activity.
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Lewis SP, Knoll AKI. Do It Yourself: Examination of Self-Injury First Aid Tips on YouTube. CYBERPSYCHOLOGY BEHAVIOR AND SOCIAL NETWORKING 2015; 18:301-4. [PMID: 25965864 DOI: 10.1089/cyber.2014.0407] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Individuals who engage in nonsuicidal self-injury (NSSI) may prefer the Internet as a medium to communicate about NSSI experiences and obtain NSSI information. Recent research suggests that NSSI first aid information is shared. Yet, no research has examined the context in which this information occurs. This study examined the nature and scope of NSSI first aid tips on YouTube using a content analysis to examine 40 NSSI first aid videos. Findings indicated that videos were viewed 157,571 total times; they were typically favorably viewed. Most had a neutral purpose and neither encouraged nor discouraged NSSI. Messages encouraging NSSI help seeking were scant. Similarly, medical help seeking was not commonly encouraged, with several videos providing "safe" NSSI instructions. Overall, videos with NSSI first aid information may contribute to NSSI reinforcement and the belief that professional and medical help may not be needed for NSSI. Findings have implications for research, clinical work, and e-outreach, which are discussed.
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Affiliation(s)
- Stephen P Lewis
- Department of Psychology, University of Guelph , Guelph, Canada
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Lewis SP, Seko Y. A Double-Edged Sword: A Review of Benefits and Risks of Online Nonsuicidal Self-Injury Activities. J Clin Psychol 2015; 72:249-62. [PMID: 26613372 DOI: 10.1002/jclp.22242] [Citation(s) in RCA: 76] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVE This review aimed to synthesize current evidence on the perceived benefits and risks of online activity pertinent to nonsuicidal self-injury (NSSI). METHOD A systematic literature search was conducted to identify peer-reviewed articles, which yielded a total of 27 articles published between 2005 and 2015. Following this, a thematic analysis was employed to identify perceived benefits and risks of online NSSI activity. RESULTS Our thematic analysis identified 4 potential benefits (mitigation of social isolation, recovery encouragement, emotional self-disclosure, curbing NSSI urges) and 3 potential risks (NSSI reinforcement, triggering NSSI urges, stigmatization of NSSI) associated with online NSSI activities. CONCLUSION Given the double-edged effect of online NSSI activities, clinicians may benefit from incorporating clients' online NSSI activity in the context of NSSI assessment and treatment. Future research ought to directly examine the link between online NSSI activity and NSSI behavior to better understand the nature of these benefits and risks.
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Lewis SP, Mehrabkhani S. Every scar tells a story: Insight into people’s self-injury scar experiences. COUNSELLING PSYCHOLOGY QUARTERLY 2015. [DOI: 10.1080/09515070.2015.1088431] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Research with adolescents who engage in non-suicidal self-injury: ethical considerations and challenges. Child Adolesc Psychiatry Ment Health 2015; 9:37. [PMID: 26417391 PMCID: PMC4584461 DOI: 10.1186/s13034-015-0071-6] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2015] [Accepted: 07/14/2015] [Indexed: 11/22/2022] Open
Abstract
Non-suicidal self-injury (NSSI) has emerged as a significant psychiatric issue among youth. In addition to its high prevalence rates, NSSI is associated with a number of psychiatric issues and confers risk for varying degrees of physical injury. It is also a risk factor for attempted suicide. Thus, youth who engage in NSSI represent a vulnerable and high-risk population and researchers are likely to encounter a variety of ethical challenges when conducting NSSI research. Accordingly, it is critical that researchers be familiar with the major ethical issues involved in NSSI research and how to effectively account for and address them. This is important both prior to obtaining clearance from their Institutional Review Boards and when carrying out their research. To date, there is no consolidated resource to delineate the ethical challenges inherent to NSSI research and how these can be effectively navigated throughout the research process. The goals of this paper are to review international best practices in NSSI research across the various contexts within which it is studied, to offer guidelines for managing these issues, to identify areas in which variation in approaches prohibits decisive recommendations, and to generate questions in need of further consideration among scholars in this field.
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Abstract
Abstract. Nonsuicidal self-injury (NSSI) is a prevalent, pervasive, clinically significant behavior in adolescents, frequently associated with serious social, physical, and psychological consequences. It is characterized by high comorbidity with various disorders. Therefore, NSSI has been included as a research diagnosis in the Diagnostic and statistical manual of mental disorders (5th ed., American Psychiatric Association (APA; 2013) ; DSM-5; Section 3), as a condition requiring further study for possible future official adoption. This is a positive step toward providing researchers with a uniform definition and criteria. This state-of-the-art article gives an overview of prevalence rates, comorbidity, clinical correlates, functions, and risk factors as well as treatment and dealing with adolescents with NSSI and their Internet activities. Furthermore, the association and differences between NSSI and suicidality as well as borderline personality disorder are reviewed. The article concludes with future directions for research, for example, the dimensional approach to classification of the Research Domain Criteria project.
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Affiliation(s)
- Tina In-Albon
- University of Koblenz-Landau, Clinical Child and Adolescent Psychology and Psychotherapy, Landau, Germany
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21
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Mitchell KJ, Wells M, Priebe G, Ybarra ML. Exposure to websites that encourage self-harm and suicide: prevalence rates and association with actual thoughts of self-harm and thoughts of suicide in the United States. J Adolesc 2014; 37:1335-44. [PMID: 25313930 DOI: 10.1016/j.adolescence.2014.09.011] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2014] [Revised: 09/09/2014] [Accepted: 09/22/2014] [Indexed: 12/19/2022]
Abstract
This article provides 12-month prevalence rates of youth exposure to websites which encourage self-harm or suicide and examines whether such exposure is related to thoughts of self-harm and thoughts of suicide in the past 30 days. Data were collected via telephone from a nationally representative survey of 1560 Internet-using youth, ages 10-17 residing in the United States. One percent (95% CI: 0.5%, 1.5%) of youth reported visiting a website that encouraged self-harm or suicide. Youth who visited such websites were seven times more likely to say they had thought about killing themselves; and 11 times more likely to think about hurting themselves, even after adjusting for several known risk factors for thoughts of self-harm and thoughts of suicide. Given that youth thinking about self-harm and suicide are more likely to visit these sites, they may represent an opportunity for identification of youth in need of crisis intervention.
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22
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Lewis SP, Michal NJ. Start, stop, and continue: Preliminary insight into the appeal of self-injury e-communities. J Health Psychol 2014; 21:250-60. [PMID: 24707032 DOI: 10.1177/1359105314527140] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Nonsuicidal self-injury e-communication has gained heightened empirical and public interest. This is the first study to examine possible motives for nonsuicidal self-injury e-communication. A total of 68 nonsuicidal self-injury e-community members responded to open-ended questions concerning reasons for starting, temporarily stopping, and continuing nonsuicidal self-injury e-communication. Results from a thematic analysis indicated that being motivated to obtain support, get nonsuicidal self-injury help, help others, and better understand nonsuicidal self-injury represented motives for starting nonsuicidal self-injury e-communication. For some, negative interactions and accessing triggering material contributed to e-communication stoppage; these individuals continued e-communication to get support and help. Implications for research and e-outreach are discussed.
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